Facilitator-guided Acceptance and Commitment Bibliotherapy for Parents of Young Children With Neurodevelopmental Disorders: A Randomised Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 154
- 试验地点
- 2
- 主要终点
- Parenting stress
研究概览
简要总结
The study aims to examine the effectiveness of a psychotherapy approach called Facilitator-guided Acceptance and Commitment Bibliotherapy (FAB) in improving the psychological health of parents of young children with neurodevelopmental disorders (NDD) and reducing the emotional and behavioral symptoms of NDD children. The study will involve 154 Cantonese-speaking parents of children aged 2-6 years diagnosed with NDD in Hong Kong. The study hopes to find that FAB can improve parent-child dyads' health outcomes by enhancing psychological flexibility, parental psychological health, and mindful parenting skills.
详细描述
Background: Neurodevelopmental disorders (NDDs) are heterogeneous disorders that typically develop in early childhood and are characterised by developmental deficits that result in impaired personal, social, and/or occupational functioning. In Hong Kong, according to the latest statistical report from the Education Bureau, it is estimated that at least 71,320 preschool and school-age children have been diagnosed with NDD and are currently receiving special education and/or health care services. It is well documented that NDD children have less clear communication signals to their parents and poorer prosocial skills.
Continued failures and difficulties in understanding and responding to children's needs may prevent parents from developing positive parenting behaviours, which can negatively impact parents' psychology and ultimately snowballing their NDD child's emotional and behavioural symptoms. To our knowledge, effective interventions that specifically target the mental health of parents caring for young children with NDD to improve outcomes for both parents and children are extremely scarce. To address this study gap, this study will implement and examine the effectiveness of the Facilitator-guided Acceptance and Commitment Bibliotherapy, a facilitator-guided manual reading psychotherapy approach that explicitly targets the psychological needs of parents, in parents of young children with NDD in On-site Pre-school Rehabilitation Service (OPRS) teams.
Objectives: To examine the effectiveness of the Facilitator-guided Acceptance and Commitment Bibliotherapy (FAB) and general parenting advice, in comparison to the control (general parenting advice only), on outcomes related to parental psychological health (parenting stress, symptoms of depression and anxiety, psychological flexibility), parenting behaviour, as well as the child's emotional and behavioural symptoms over 6 months of post-intervention period.
Hypotheses to be tested: Compared to the control group alone, FAB participation could achieve the following goals: reduce parents' parenting stress and NDD children's emotional and behavioural symptoms, reduce parental depressive and anxiety symptoms, improve psychological flexibility and nurturing behaviours of mindful parenting, and reduce the use of health care and rehabilitation services for young children with NDD over 6 months of post-intervention period.
Design: A multi-centre, two-arm randomised controlled trial (RCT) with a repeated-measures parallel-group design
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Triple (Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 21 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Parents of young children with NDD who fulfil the following criteria will be recruited:
- •Cantonese-speaking Hong Kong residents,
- •aged ≥ 21 years,
- •have a child aged between two and six years old (preschool age) with a clinically documented diagnosis/suspected NDD diagnosis according to DSM-5 criteria (e.g., ASD, ADHD, developmental delay) and enrolled in the SWD subvented pre-school rehabilitation services offered by NGOs,
- •caregivers who adopted the responsibility of taking care of the child, living together with the child, and
- •have device(s) with internet access.
- •Parents of young children with NDD will be excluded if:
- •has been diagnosed with severe mental illness(es),
- •cognitive/language/communication/visual/hearing impairment(s) or disorders that may present difficulties in comprehending the content of the intervention; and/or
- •are currently receiving another psychosocial, psychoeducational, or parenting intervention(s).
排除标准
- 未提供
研究组 & 干预措施
Facilitator-guided Acceptance and Commitment Bibliotherapy (FAB)
A 12-week facilitator-guided Acceptance and Commitment Bibliotherapy, which includes general parenting advice and is delivered via a website
干预措施: Facilitator-guided Acceptance and Commitment Bibliotherapy (FAB) (Behavioral)
Control Group
Routine family support services and four video-conferencing sessions over the course of 12 weeks
干预措施: General Parenting Education and Advice (Behavioral)
结局指标
主要结局
Parenting stress
时间窗: Change from baseline assessment to immediate and 6 months post-intervention
The Parenting Stress Index-Short Form (PSI-SF, 36 items, 5-point Likert scale). The PSI-SF evaluates parenting stress in three dimensions: parental distress, parent-child dysfunctional interaction, and difficult child behaviour (12 items each), with all items summed to indicate the total parenting stress \[48\]. Parents are asked to rate how much they agree or disagree with each statement using a 5-point Likert scale, ranging from "strongly agree" to "strongly disagree". Higher scores indicate higher levels of parenting stress. The Chinese version of PSI-SF (and its subscales) demonstrated strong convergent validity, discriminant validity and internal consistency (α =.79-.88) in Chinese parents.
Child's emotional and behavioural symptoms
时间窗: Change from baseline assessment to immediate and 6 months post-intervention
The Strengths and Difficulties Questionnaire (SDQ, 25 items, 3-point Likert scale). The SDQ consists of 25 items that assess five domains: emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, and prosocial behavior. Each item is rated on a 3-point Likert scale, with higher scores indicating greater symptom severity for the emotional and behavioral problem domains and greater prosocial behavior for the prosocial behavior domain. The Chinese version of SDQ reported adequate test-retest reliabilities (ICC=.75-.86) and discriminant validity in Hong Kong parents.
次要结局
- Parenting behaviour(Change from baseline assessment to immediate and 6 months post-intervention)
- Child's use of health care and rehabilitation services(Change from baseline assessment to immediate and 6 months post-intervention)
- Parental symptoms of anxiety and depression(Change from baseline assessment to immediate and 6 months post-intervention)
- Parental psychological flexibility(Change from baseline assessment to immediate and 6 months post-intervention)
研究者
Yuen Yu CHONG
Assistant Professor
Chinese University of Hong Kong